Rational Pharmacotherapy in Cardiology

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Drug-Induced Atrial Fibrillation / Atrial Flutter

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Drug-induced atrial fibrillation / flutter (DIAF) is a serious and potentially life-threatening complication of pharmacotherapy. Purpose of the work: systematization and analysis of scientific literature data on drugs, the use of which can cause the development of DIAF, as well as on epidemiology, pathophysiological mechanisms, risk factors, clinical picture, diagnosis and differential diagnosis, treatment and prevention of DIAF. Analysis of the literature has shown that many groups of drugs can cause the development of DIAF, with a greater frequency while taking anticancer drugs, drugs for the treatment of the cardiovascular, bronchopulmonary and central nervous systems. The mechanisms and main risk factors for the development of DIAF have not been finally established and are known only for certain drugs, therefore, this section requires further study. The main symptoms of DIAF are due to the severity of tachycardia and their influence on the parameters of central hemodynamics. For diagnosis, it is necessary to conduct an electrocardiogram (ECG) and Holter monitoring of an ECG and echocardiography. Differential diagnosis should be made with AF, which may be caused by other causes, as well as other rhythm and conduction disturbances. Successful treatment of DIAF is based on the principle of rapid recognition and immediate discontinuation of drugs (if possible), the use of which potentially caused the development of adverse drug reactions (ADR). The choice of management strategy: heart rate control or rhythm control, as well as the method of achievement (medication or non-medication), depends on the specific clinical situation. For the prevention of DIAF, it is necessary to instruct patients about possible symptoms and recommend self-monitoring of the pulse. It is important for practitioners to be wary of the risk of DIAF due to the variety of drugs that can potentially cause this ADR.

About the Authors

O. D Ostroumova
Russian Medical Academy of Continuing Professional Education
Russian Federation

Olga D. Ostroumova.


eLibrary  SPIN  3910-6585

M. S. Chernyaeva
Central State Medical Academy of the Administrative Department of the President; Hospital for War Veterans No. 2
Russian Federation

Marina S. Cherniaeva.


eLibrary  SPIN  2244-0320

A. I. Kochetkov
Russian Medical Academy of Continuing Professional Education
Russian Federation

Aleksey I. Kochetkov.


eLibrary  SPIN  9212-6010

A. E. Vorobieva
Moscow State University of Medicine and Dentistry named after A.I. Evdokimova
Russian Federation

Anastasiya E. Vorobyova.


eLibrary SPIN 8579-3163

D. I. Bakhteeva
Hospital for War Veterans No. 2
Russian Federation

Damiry I. Bakhteeva.


eLibrary  SPIN  3664-5299

S. P. Korchagina
MedSwiss Medical Center
Russian Federation

Stella P. Korchagina.


eLibrary SPIN 4006-4669

O. V. Bondarets
Moscow State University of Medicine and Dentistry named after A.I. Evdokimova
Russian Federation

Olga V. Bondarec.


eLibrary SPIN 7785-0655

N. D. Boyko
Hospital for War Veterans No. 2
Russian Federation

Natalya D. Boyko.


eLibrary SPIN 5018-1458

D. A. Sychev
Russian Medical Academy of Continuing Professional Education
Russian Federation

Dmitry A. Sychev.


eLibrary SPIN 4525-7556


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For citation:

Ostroumova O.D., Chernyaeva M.S., Kochetkov A.I., Vorobieva A.E., Bakhteeva D.I., Korchagina S.P., Bondarets O.V., Boyko N.D., Sychev D.A. Drug-Induced Atrial Fibrillation / Atrial Flutter. Rational Pharmacotherapy in Cardiology. 2021;17(6):e1-e18. (In Russ.)

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